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Cognitive and anxiety symptoms in screening for clinical depression in diabetes: a systematic examination of diagnostic performances of the HADS and BDI-SF.
J Affect Disord. 2010 Jun; 123(1-3):332-6.JA

Abstract

BACKGROUND

Little systematic research into the diagnostic performance of instruments used to screen for clinical depression is available for people with diabetes. The objective of this study was to compare performances of the HADS and BDI-SF and their components in association with a standard diagnostic interview.

METHODS

In a sample of 298 French outpatients from a diabetes clinic (165 men, aged 59.4 + or - 10.7 years), we assessed diagnoses of clinical depression (CD, n=42) and major depression (MD, n=30) using the MINI and administered the HADS and BDI-SF.

RESULTS

Cognitive symptoms from the BDI-SF (BDIcog) were more closely associated with MD than CD. BDIcog and HADS total scores performed best overall in identifying clinical depression (AUCs under ROC curve 85%). For identification of CD, the sensitivity/specificity of BDI cognitive symptoms was 88/71% (cutoff 3+) and for the HADS 83/65% (cutoff 13+). For identification of MD, BDIcog scored 83/80% (cutoff 4+) and HAD-A 80/76% (cutoff 9+). Logistic regression analyses further suggested that BDIcog and HAD-A discriminated between depressed and non-depressed patients better than the somatic and anhedonia items present in the same scales. The depression subscale of the HADS performed poorly.

LIMITATIONS

The consecutive nature of the sample may limit the generalizability of our findings.

CONCLUSION

Results suggest that, in addition to depressed mood, both negative thoughts and anxiety are core elements for the correct identification of clinical depression in chronic illnesses such as diabetes. It may be more appropriate to use the total score when applying the HADS and distinguish non-somatic symptoms within the BDI.

Authors+Show Affiliations

Université Paris Descartes, France. serge.sultan@parisdescartes.frNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19861228

Citation

Sultan, Serge, et al. "Cognitive and Anxiety Symptoms in Screening for Clinical Depression in Diabetes: a Systematic Examination of Diagnostic Performances of the HADS and BDI-SF." Journal of Affective Disorders, vol. 123, no. 1-3, 2010, pp. 332-6.
Sultan S, Luminet O, Hartemann A. Cognitive and anxiety symptoms in screening for clinical depression in diabetes: a systematic examination of diagnostic performances of the HADS and BDI-SF. J Affect Disord. 2010;123(1-3):332-6.
Sultan, S., Luminet, O., & Hartemann, A. (2010). Cognitive and anxiety symptoms in screening for clinical depression in diabetes: a systematic examination of diagnostic performances of the HADS and BDI-SF. Journal of Affective Disorders, 123(1-3), 332-6. https://doi.org/10.1016/j.jad.2009.09.022
Sultan S, Luminet O, Hartemann A. Cognitive and Anxiety Symptoms in Screening for Clinical Depression in Diabetes: a Systematic Examination of Diagnostic Performances of the HADS and BDI-SF. J Affect Disord. 2010;123(1-3):332-6. PubMed PMID: 19861228.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognitive and anxiety symptoms in screening for clinical depression in diabetes: a systematic examination of diagnostic performances of the HADS and BDI-SF. AU - Sultan,Serge, AU - Luminet,Olivier, AU - Hartemann,Agnès, Y1 - 2009/10/25/ PY - 2009/07/21/received PY - 2009/09/29/revised PY - 2009/09/29/accepted PY - 2009/10/29/entrez PY - 2009/10/29/pubmed PY - 2010/7/27/medline SP - 332 EP - 6 JF - Journal of affective disorders JO - J Affect Disord VL - 123 IS - 1-3 N2 - BACKGROUND: Little systematic research into the diagnostic performance of instruments used to screen for clinical depression is available for people with diabetes. The objective of this study was to compare performances of the HADS and BDI-SF and their components in association with a standard diagnostic interview. METHODS: In a sample of 298 French outpatients from a diabetes clinic (165 men, aged 59.4 + or - 10.7 years), we assessed diagnoses of clinical depression (CD, n=42) and major depression (MD, n=30) using the MINI and administered the HADS and BDI-SF. RESULTS: Cognitive symptoms from the BDI-SF (BDIcog) were more closely associated with MD than CD. BDIcog and HADS total scores performed best overall in identifying clinical depression (AUCs under ROC curve 85%). For identification of CD, the sensitivity/specificity of BDI cognitive symptoms was 88/71% (cutoff 3+) and for the HADS 83/65% (cutoff 13+). For identification of MD, BDIcog scored 83/80% (cutoff 4+) and HAD-A 80/76% (cutoff 9+). Logistic regression analyses further suggested that BDIcog and HAD-A discriminated between depressed and non-depressed patients better than the somatic and anhedonia items present in the same scales. The depression subscale of the HADS performed poorly. LIMITATIONS: The consecutive nature of the sample may limit the generalizability of our findings. CONCLUSION: Results suggest that, in addition to depressed mood, both negative thoughts and anxiety are core elements for the correct identification of clinical depression in chronic illnesses such as diabetes. It may be more appropriate to use the total score when applying the HADS and distinguish non-somatic symptoms within the BDI. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/19861228/Cognitive_and_anxiety_symptoms_in_screening_for_clinical_depression_in_diabetes:_a_systematic_examination_of_diagnostic_performances_of_the_HADS_and_BDI_SF_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(09)00440-6 DB - PRIME DP - Unbound Medicine ER -